Ossification of the posterior longitudinal ligament of the thoracic spine
Introduction
Introduction to ossification of the posterior longitudinal ligament of thoracic spine The posterior longitudinal ligament ossification of the thoracic spine (OPLL) is not a common disease worldwide, but in some countries in the Far East, it is not uncommon to see a patient with a sacral ligament in the distal ligament and go to the hospital. The posterior longitudinal ligament of the thoracic spine is ossified. The onset is also very rare in Japan. Sometimes it can be found in the cervical spine OPLL patients undergoing a full spine film examination, but some patients only have chest spinal cord lesions without cervical spinal cord lesions. basic knowledge The proportion of illness: the incidence rate is about 0.004%-0.005% Susceptible people: no special people Mode of infection: non-infectious Complications:
Cause
Causes of ossification of the posterior longitudinal ligament of the thoracic spine
(1) Causes of the disease
The cause is not yet clear.
(two) pathogenesis
Like other parts of the posterior longitudinal ligament ossification, the pathogenesis of thoracic OPLL is not known, it is generally considered to be caused by heterotopic ossification of chondrocytes, but some scholars believe that it is related to fibrocartilage and membrane internalization, and Scholars believe that degenerated intervertebral discs can affect the formation of ossification of the posterior longitudinal ligament.
Prevention
Prevention of ossification of the posterior longitudinal ligament of thoracic spine
Needless attention, mainly pay more attention to the usual life, early detection and early treatment is better.
Complication
Thoracic ossification of the posterior longitudinal ligament Complications
Can be complicated by complete paralysis of the lower extremities.
Symptom
Symptoms of ossification of the posterior longitudinal ligament of the thoracic spine Common symptoms Inability to sustained chest pain... Easy to fall feeling dysfunction Spinal cord compression back pain ligament ossification defecation disorder
1. Back pain: OPLL-induced thoracic lesions can only occur after a short period of time from the onset of the disease to complete convulsions, but some patients only complain of persistent back-eye pain when they go to the hospital for treatment. Their medical history can last for several months to several years. In the year, Kenji Hannai reported 12 patients with anterior surgery who complained of persistent chest pain or blurred back pain.
2. Lower limb paralysis: can be from mild exercise weakness to severe lower extremity complete paralysis, and can be accompanied by varying degrees of sensory impairment, the patient's paralysis symptoms are progressively worse.
3. Abnormal urination function: depending on the degree of lesions, there may be weakness in the urine and stool, large infestation, urinary incontinence.
4. Unstable walking: the lower limbs are weak, and there is a feeling of squatting or a foot on the cotton, which is easy to fall.
Examine
Examination of ossification of the posterior longitudinal ligament of the thoracic spine
1. X-ray examination: the lateral ligament of the thoracic vertebrae or the tomographic X-ray film can often be found to have a high density shadow of the posterior longitudinal ligament, which can be continuous or isolated.
2. Myelography: It can show the range of bone formation, which has great significance for determining the range of decompression.
3. CT examination: has a clear diagnostic significance, and can measure the rate of spinal stenosis. CT three-dimensional reconstruction can not only show the extent and shape of the bone, but also the degree of spinal cord compression.
4. MRI examination: It can show the extent and range of spinal cord compression.
Diagnosis
Diagnosis and differentiation of ossification of the posterior longitudinal ligament of thoracic spine
The diagnosis of thoracic OPLL is mainly based on:
1. Clinical manifestations: mainly the vague pain of the back and the symptoms of lower extremity spasm.
2. Imaging examination
(1) X-ray examination: The lateral ligament of the thoracic vertebrae or the tomographic X-ray film can often be found to have a high-density shadow of the posterior longitudinal ligament, which can be continuous or isolated.
(2) Myelography: The range of bone formation can be displayed, which has great significance for determining the range of decompression.
(3) CT examination: has a clear diagnostic significance, and can measure the rate of spinal stenosis (Figure 1), CT three-dimensional reconstruction can show the extent, morphology, and degree of spinal cord compression.
(4) MRI examination: It can show the extent and range of spinal cord compression.
